Medications

Medications Available

The medications below may be prescribed as adjuncts to diet and exercise for treatment of obesity while on our Medical Weight Loss Program. The medications we use are listed below along with an explanation of how they are prescribed and possible side effects.

Pancreatic Lipase Inhibitor (Approved for Long-Term Use)

OrlistatHow to take: 120 mg three times daily with fat-containing meals. A reduced dose of 60 mg¶ is an option for patients who do not tolerate 120 mg. Not a controlled substance

Side effects: Nausea, vomiting, diarrhea, constipation, hypoglycemia in patients with T2DM (more common if used in conjunction with diabetes medications known to cause hypoglycemia), injection site reactions, increased lipase, increased heart rate. Rarely reported: pancreatitis, gallbladder disease, renal impairment, suicidal thoughts. Advise patients to avoid dehydration in relation to GI side effects. Monitor blood glucose in diabetic patients and adjust co-administered sulfonylureas (eg, reduce dose by 50 percent) and other anti-diabetic medications as needed to prevent potentially severe hypoglycemia. Causes a modest delay of gastric emptying. Use is not recommended in severe renal impairment (CrCl Possible increase in thyroid cancer risk based on murine model data. Contraindicated in pregnancy and in patients with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia 2A or 2B.

Noradrenergic Sympathomimetic Drugs (Approved for Short-Term Use)

BenzphetamineHow to take: Initial: 25 mg once daily; may titrate up to 25 to 50 mg one to three times daily. C-III

Applies to all sympathomimetic agents: Due to their side effects and potential for abuse, we suggest not prescribing sympathomimetics for weight loss. If prescribed, limit to short-term (≤12 weeks) use.

Δ FDA recommends warning young adults (age 18 to 24 years) of the risk of becoming suicidal during initial treatment of psychiatric disorders with any antidepressant. ◊ According to United States labeling, if weight loss is not ≥4 percent after 16 weeks or 3 mg/week is not tolerated, discontinue use. Labeling in the European Union recommends discontinuation of use if weight loss is not ≥5 percent after 12 weeks of 3 mg/week.